Top

Osteoporosis International

Published in:

01-03-2013 | Original Article

Updated fracture incidence rates for the Italian version of FRAX®

Authors: P. Piscitelli, G. Chitano, H. Johannson, M. L. Brandi, J. A. Kanis, D. M. Black

Published in: Osteoporosis International | Issue 3/2013

Abstract

Summary

In order to update data underlying the Italian version of FRAX, we computed the national hip fracture incidence in Italy from hospitalization records for the year 2008. Mortality data and 10-year probabilities of major osteoporotic fractures were also updated. This revision will improve FRAX accuracy and reliability.

Introduction

The original Italian version of FRAX® was based on five regional estimates of hip fracture risk undertaken up to 20 years previously. Our objective was to update hip fracture rates for the model with more recently derived data from the whole Italian population and more recent data on mortality.

Methods

We analyzed the Italian national hospitalization database for the year 2008 in order to compute age- and sex-specific hip fracture incidence rates. Re-hospitalisations of the same patients within 1 year were excluded from the analysis. Hip fracture incidence rates were computed for the age range of 40–100 years, whereas the original FRAX model lacked data on the youngest and oldest age groups. In addition, we used the national mortality data for the same year 2008 to update the model. Ten-year fracture probabilities were re-calculated on the basis of the new fracture incidence rates.

Results

The new hip fracture age- and sex-specific incidence rates were close to those used in the original FRAX tool, although some significant differences (not exceeding 25–30 %) were found for men aged 65–75 years and women under 55 years of age. In general, the revision resulted in decreased estimated 10-year probabilities in the younger age groups, whilst those in the older age groups were slightly increased.

Conclusions

The Italian version of FRAX has been updated using the new fracture incidence rates. The impact of these revisions on FRAX is likely to increase the accuracy and reliability of FRAX in estimating 10-year fracture probabilities.

Italian Statistics 2008 (2009) National Institute of Statistics, Rome

Ferrario M, Chiodini P, Chambless LE et al (2005) Prediction of coronary events in a low incidence population. Assessing accuracy of the CUORE cohort study prediction equation. Int J Epidemiol 34:413–21PubMedCrossRef

Conroy RM, Pyörälä K, Fitzgerald AP et al (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003PubMedCrossRef

Elffors L, Allander E, Kanis JA et al (1994) The variable incidence of hip fracture in southern Europe: the MEDOS study. Osteoporos Int 4:253–263PubMedCrossRef

Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Oglesby A (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244PubMedCrossRef

Kanis JA, Hans D, Cooper C et al (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22:395–411

Cooper C, Cole ZA, Holroyd CR et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288PubMedCrossRef

Ettinger B, Black DM, Dawson-Hughes B et al (2010) Updated fracture incidence rates for the US version of FRAX®. Osteoporos Int 21:25–33PubMedCrossRef

Tuzun S, Eskiyurt N, Akarırmak U et al (2012) Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int 23(3):949–955PubMedCrossRef

10.

Stepan JJ, Vaculik J, Pavelka K, Zofka J, Johansson H, Kanis JA (2012) Hip fracture incidence between years 1981 and 2009 and construction of a FRAX® model for the assessment of fracture probability in the Czech Republic. Calcified Tissue International (in press)

11.

Piscitelli P, Guida G, Iolascon G et al (2007) Incidence and costs of hip fractures vs. acute myocardial infarction in the Italian population: a 4 years survey. Osteoporos Int 18:211–219PubMedCrossRef

12.

Icks A, Haastert B, Becker C, Meyer G (2008) Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 19:1139–1145PubMedCrossRef

13.

Maravic M, Le Bihan C, Landais P, Fardellone P (2005) Incidence and cost of osteoporotic fractures in France during 2001. A methodological approach by the national hospital database. Osteoporos Int 16:1475–1480PubMedCrossRef

14.

Dimai HP, Svedbom A, Fahrleitner-Pammer A et al (2011) Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 22(2):685–92PubMedCrossRef

15.

Lippuner K, von Overbeck J, Perrelet R et al (1997) Incidence and direct medical costs of hospitalizations due to osteoporotic fractures in Switzerland. Osteoporos Int 7:414PubMedCrossRef

16.

Johnell O, Gullberg B, Allander E, Kanis JA (1992) The apparent incidence of hip fracture in Europe: a study of national register sources. Osteoporos Int 2:298–302PubMedCrossRef

17.

Pervez H, Bhargwa A, Parker MJ (2003) Accuracy and reliability of the clinical indicators related to hip fractures. Injury 34:522–524PubMedCrossRef

18.

Kanis JA, Oden A, Johnell O et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427PubMedCrossRef

19.

Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19(4):385–397PubMedCrossRef

20.

Oden A, Dawson A, Dere W, Johnell O, Jonsson B, Kanis JA (1998) Lifetime risk of hip fractures is underestimated. Osteoporos Int 8(6):599–603PubMedCrossRef

21.

De Laet C, Kanis JA, Oden A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–38PubMedCrossRef

22.

Kanis JA, Oden A, Johnell H et al (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–46PubMedCrossRef

23.

Compston J, Cooper A, Cooper C et al (2009) Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK. Maturitas 62:105–108PubMedCrossRef

24.

Grossman JM, Gordon R, Ranganath VK et al (2010) American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 62:1515–26CrossRef

25.

Dawson-Hughes B (2008) A revised clinician's guide to the prevention and treatment of osteoporosis. J Clin Endocrinol Metab 93:2463–65PubMedCrossRef

26.

Association Suisse contre l’Ostéoporose ASCO (2010) Ostéoporose—Recommandations 2010. Available at http://www.svgo.ch/content/documents/ASCO_Recommandation2010_V19avril2010.pdf

27.

Papaioannou A, Morin S, Cheung AM et al (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182:1864–73PubMedCrossRef

28.

Kanis JA, Burlet N, Cooper C et al (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428PubMedCrossRef

29.

Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674PubMedCrossRef

30.

Kanis JA, Johnell O, Oden A et al (2005) Intervention thresholds for osteoporosis in men and women: a study based on data from Sweden. Osteoporos Int 16:6–14PubMedCrossRef

Title: Updated fracture incidence rates for the Italian version of FRAX®
Authors: P. Piscitelli
G. Chitano
H. Johannson
M. L. Brandi
J. A. Kanis
D. M. Black
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 3/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-012-2021-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Updated fracture incidence rates for the Italian version of FRAX®

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2013

Cost and management of males with closed fractures

Sarcopenia and osteopenia among 70–80-year-old home-dwelling Finnish women: prevalence and association with functional performance

Inhibition of osteoclast differentiation and matrix metalloproteinase production by CD4+CD25+ T cells in mice

Treatment of hydrogen molecule abates oxidative stress and alleviates bone loss induced by modeled microgravity in rats

Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study

FGF23: instability may affect accuracy and interpretation